The HIV vaccine field is just now beginning to recover from the disappointments of prior large-scale vaccine studies and is beginning to show momentum, but where is that momentum headed? While much has been learned from those prior studies and vaccinology in general, one could well argue that HIV vaccine efforts are not as robust as they could be, likewise they do not take into consideration the overall picture of the requirements for an HIV vaccine. In particular, AIDS is a pandemic requiring cost-effective treatment. Even a partially active vaccine would have great benefit if they were cost-effective, easy to use and safe.
Brush more, floss more, use automated toothbrushes, a water pik, or place sulcular antibiotics?
What regimens are you currently recommending in your office for your patients’ oral hygiene maintenance and prevention? What if I told you that mechanical removal of bad bacteria might not be enough to ensure optimal oral health in all of your patients? After all, if simple removal of bacteria was beneficial then mouth washes would rein supreme chemical adjunct to mechanical removal. The problem is that this chemical warfare kills all types of oral bacteria, including the good!
An important study called REPRIEVE, aims to answer some important questions regarding heart disease risk for people living with HIV. The Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE), or A5332, is a multi-centered, mainly US based, study is investigating the use of prophylactic statin therapy as a preventative method against cardiovascular disease (CVD) in HIV-positive people. REPRIEVE is one of the largest prospective interventional studies to be conducted among HIV patients, and the first major study to widely test a prevention strategy for cardiovascular disease in the HIV population. If successful, the prophylactic use of statins could provide an important means of significantly reducing the occurrence of heart disease in the HIV-positive population.
HIV among the Latino community is on the rise with Latinos representing 21% of all new HIV infections, yet only 13% of the U.S. population. It is estimated that 23% of the 1.2 million people living with HIV in the United States in 2012 were Latinos. The rate of HIV infection in Latinos is more than three times that of non- Hispanic whites. Latino’s are usually in later stages of HIV disease when diagnosed and experience significant barriers to treatment. The CDC reports that 54.8% of Latinos living with HIV are retained in treatment with 43.3% prescribed antiretroviral treatment and 35.6% achieving viral suppression. Risk factors attributed to Latinos are intravenous drug use, multiple sexual partners and male- to- male transmission.
Antiretroviral therapy has dramatically increased the life span of HIV patients. Despite this, people living with HIV experience other devastating illnesses, such as cardiovascular disease (CVD), at a significant rate. Cardiovascular diseases and related conditions often seen in people living with HIV include coronary artery disease, heart attack, pulmonary hypertension, heart failure and stroke.